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HomeMy WebLinkAbout200612 08/17/2011 CITY OF CARMEL, INDIANA VENDOR: 365616 Page 1 of 1 ONE CIVIC SQUARE AMUDHA SAMUEL CARMEL, INDIANA 46032 3336 KILKENNY CIRCLE CHECK AMOUNT: $48.00 CARMEL IN 46032 CHECK NUMBER: 200612 CHECK DATE: 8/17/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1096 4358400 48.00 REFUNDS AWARDS INDE ACTIVITY REFUND RECEIPT Receipt 699256 Payment Date: 08/01/11 Household 9861 Monon Community Center Amudha Samuel Hm Ph: (317)733 -2222 Carmel IN 46032 3336 Kilkenny Circle Carmel IN 46032 Cell Ph: (317)319 -3811 Phone: (317)848 -7275 amudhasamuel@gmaii.com Fed Tax ID #35- 6000972 Enrollment Details CANCELLATION Refund Of 48.00 Enrollee Name: Aster Samuel Fees Tax Discount Prev Paid Cur Paid Amount Due Activity Number: 116425 -03 Safe Sitter 7.00 0.00 0.00 7.00 0.00 Enrollment Date: 04/28/2011 (Cancelled) Primary Instructor: CCPR Staff no 13 0 9 1^"/ Class Location: Program Rms A, B, C Class Dates: 08/20/2011 to 08/20/2011 J� Monon Community Cntr 9:OOA to 4:OOP A Sa AUG 0 4 2011 Carmel IN 46032 Scheduled Sessions: 1 (317)848 -7275 Cancel Reason: advanced request`' PREVIOUS NET HOUSEHOLD BALANCE 0.00 Processed on 08/01/11 15:32:06 by LVA FEES CHANGED ON CANCELLED ITEMS 55.00 SURCHARGE APPLIED AGAINST CANCELLED FEES Z.00- NET AMOUNT FROM CANCELLED ITEMS TOTAL AMOUNT AMOUNT REFUNDED 4850 NEW NET HOUSEHOLD BALANCE 0.00 Refund of 48.00 Made By REFUND FINAN With Reference advanced request All refunds are subject to State Board of Accounts claim procedure and may take 4 -6 weeks to process. A check will be iss* Authorized d N ash or cre 't card refunds. Sigq lure Date Authgn Gn ure D to Join us for St. Vincent Tour de Carmel, a bike ride along 10 -mile and 20 -mile routes through the city of Carmel. Rest stops will have a variety of healthy snacks, drinks and entertainment. After the ride, the finish line will offer more entertainment and refreshments. The cost is $8 per rider ($10 for same- dayday -of registration). Pre- register online at www.carmelclayparks.com or pick up a form at the Monon Community Center. All participants will receive a goodie bag and a T -shirt if registered on or before August 26. The Adaptive 10 -mile Ride is for individuals with special needs only. Individuals will ride as a group on the 10 -mile route. Staff will be staggered within the group throughout the ride. Group will meet at the Monon Community Center in the designated tent at the start line for check -in at 8:00 a.m. Group will begin the ride at 8:30 a.m. sharp. V00 Page 1 5 ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Samuel, Amudha Terms 3336 Kilkenny Circle Date Due Carmel, IN 46032 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 8/1/11 699256 Refund 48.00 Total 48.00 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6 20_ Clerk- Treasurer Voucher No. Warrant No. Samuel, Amudha Allowed 20 3336 Kilkenny Circle Carmel, IN 46032 In Sum of 48.00 ON ACCOUNT OF APPROPRIATION FOR 109 Monon Center PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members Dept 1096.42 699256 4358400 48.00 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 9 -Aug 2011 1 A "fm Signature 48.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund